EC Ophthalmology

Background/Aims: Heterologous serum drops are the main treatment of ligneous conjunctivitis, but they are not available worldwide. This study has described a new approach to ligneous conjunctivitis treatment.

Methods: Topical heterologous blood drops were administered - 2 to 4 times a day, for one year- in the eyes of a patient with advanced ligneous conjunctivitis, with no longer access to heterologous serum and no response to conventional treatment.

Results: The patient presented partial pseudomembrane and eye secretion regression.

Conclusion: The administration of topical heterologous blood drops would be a reasonable, accessible and inexpensive treatment for ligneous conjunctivitis in places where topical or systemic plasminogen replacement therapy is unavailable.

 Keywords: Child Health (Paediatrics); Conjunctiva; Inflammation; Ocular Surface; Case Report

1. Schuster V and Seregard S. “Ligneous conjunctivitis”. Survey of Ophthalmology 4 (2003): 369-388.
2. Tefs K., et al. “Molecular and clinical spectrum of type I plasminogen deficiency: A series of 50 patients”. Blood9 (2006): 3021-3026.
3. Watts P., et al. “Effective treatment of ligneous conjunctivitis with topical plasminogen”. American Journal of Ophthalmology 4 (2002): 451-455.
4. Martins TGDS., et al. “Treatment of ligneous conjunctivitis with heterologous serum”. Einstein (Sao Paulo) 3 (2019): eRC4714.
5. Than J., et al. “Fingerprick autologous blood: a novel treatment for dry eye syndrome”. Eye (London)12 (2017): 1655-1663.
6. Bauer M., et al. “Conjunctivitis lignosa [Ligneous conjunctivitis]”. Ophthalmologe5 (2016): 416-419.
7. Maamri A., et al. “Recurrent ligneous conjunctivitis after cataract surgery in a 67-year-old male patient: a case report”. BMC Ophthalmology1 (2022): 103.
8. Kızılocak H., et al. “Treatment of plasminogen deficiency patients with fresh frozen plasma”. Pediatric Blood and Cancer 2 (2017): e26779.
9. Ang MJ., et al. “Topical plasminogen as adjunctive treatment in recurrent ligneous conjunctivitis”. Ophthalmic Plastic and Reconstructive Surgery 2 (2017): e37-e39.
10. Shapiro AD., et al. “An international registry of patients with plasminogen deficiency (HISTORY)”. Haematologica3 (2020): 554-561.
11. Shapiro AD., et al. “Plasminogen replacement therapy for the treatment of children and adults with congenital plasminogen deficiency”. Blood12 (2018): 1301-1310.
12. Mérigot C., et al. “Approvisionnement hospitalier en plasminogene humain substitutif pour le traitement de la conjonctivite ligneuse: comment faire en pratique?” Journal Français d'Ophtalmologie 7 (2021): 1008-1020.
13. Lei N° 10.205, de 21 de março de 2001. Diário Oficial da União (2001).
14. Agência Nacional de Vigilância Sanitária - Anvisa. RDC Nº34, de 11 de junho de 2014. Diário Oficial União (2014).
15. Portaria de consolidação Nº 5, de 28 de setembro de 2017. Diário Oficial União (2017).
16. Adati M., et al. “Fresh frozen plasma: pharmaceutical input for the production of plasma-derived medicines”. Visa em Debate2 (2019): 51-61.
17. Lily Vidal JA and Bautista DV. “Use of topical allogenic fresh-frozen plasma drops in the treatment of ligneous conjunctivitis”. Canadian Journal of Ophthalmology 4 (2022): e146-e150.
18. Shamim MM., et al. “Treatment of ligneous conjunctivitis using topical plasminogen therapy in an 8-week-old female infant”. Journal of Pediatric Ophthalmology and Strabismus 55 (2018): e30-e32.
19. Bernabei F., et al. “Blood-based treatments for severe dry eye disease: the need of a consensus”. Journal of Clinical Medicine 9 (2019): 1478.
20. Mehta R and Shapiro AD. “Plasminogen deficiency”. Haemophilia6 (2008): 1261-1268.